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FALL/WINTER '00 This is the forty-fifth newsletter circulated to all of our patients, parents and colleagues.  As has always been the case, we hope that you will find its content both informative and thought provoking. As well, we would like you to feel comfortable to express suggestions and opinions that will aid us in continuing to improve our services to you.  Please feel free to speak with any of us at any time. ELECTION 2000 In our previous newsletter, I had believed that the Republican Party might make a change of direction by possibly selecting Arizona senator John McCain whose ideas could be considered quite "liberal" on a relative basis to the tenets of his Party.  However, the traditional "conservative bias" has prevailed with the selection of governor George W. Bush as its standard-bearer.  While those of you who have read many of our previous newsletters know, I have never been a fan of president Clinton or for that matter, Vice-President Gore.  Clearly, the president’s personal behavior has tarnished the office almost as never before.  Nonetheless, if we answer the question that is posed at each election, "Are you better off than you were eight years ago?", the answer, at least in economic terms would definitely be a "Yes".  The question is whether the current administration is responsible for that or was it the gridlock and other scandalous distractions in Washington that prevented the administration from over governing allowing the private sector to do what it does best -- grow. If we all remember, Bill Clinton rode into the office understanding that it was, "…the economy, stupid" that would drive the electorate’s thought processes and it is clear that Gore will make preservation of the strong economy we are now enjoying a central theme of his pleas to the people. While I basically thought very highly of governor Bush’s father, in 1992 I was moved to reject his handling of an economy that was clearly in great trouble and so I cast my vote for Ross Perot. I had decided early on that Clinton’s personal integrity was in serious question.  Unfortunately, on that score, I and twenty million other voters were proved correct.  With Vice-President Gore’s selection of our own senator Joseph Lieberman, a man of unquestioned moral integrity, Al Gore has attempted to make a statement to distance himself from the behavior of the President.  It may be that Gore himself is a person of higher moral character than the president.  I would imagine that as the real campaign gets underway after Labor day that both parties will make attempts to undermine the character of the nominees and that very little of the real issues such as Healthcare, Social Security, Gun-Control and Human Rights will be discussed in any substantive detail.  Clearly, the most visible difference between the nominees is their position on a woman’s right to choose and globally the government’s level of control over personal freedom. Political analysts have already concluded that there is tremendous apathy among the electorate due to the incredible lack of "charisma" on the part of either presidential candidate.  Hopefully, the planned “debates” will precisely define the intrinsic differences between the two parties and the candidates themselves.  As I have opined many times before, the right to vote is a precious commodity bought and paid for with the blood and lives of millions of our forebears.  As we truly enter the “new-millennium”, we have an opportunity to alter the direction of our society; a chance to regain much of the moral credibility squandered by Bill Clinton.  It is my personal belief that this issue is vital because the example set by whatever leader we choose will positively or negatively guide the behavior of the young citizens who will succeed us for generations to come.  So, please pay close attention during this pre-election campaign and cast your vote for whomever you decide will best represent the interests of our great country and your own interests in particular.  I do not believe that the two are at odds. HEALTHCARE/MANAGED-CARE Again, as those of you who have read these columns are aware, this has definitely been a "hot-button" issue for our readers and me.  Unfortunately, many of my negative predictions as to the future of this growing “system” have and are proving to be true.  Millions of "senior-citizens" have discovered to their dismay that many of the Health-Maintenance Organizations are no longer choosing to accept members who are insured by the government Medicare program because the HMO’s say that the reimbursement for their participating “providers” is an economic loss.  Because the government has delegated the management of healthcare to these HMO’s there is nothing in place which will pay for senior’s medical care expenses at a time when the cost of these services is so high that personal payment by most of them is simply impossible.  The net effect is that millions of our elderly population is effectively without healthcare.  Impossible you say; the government "promised" these people that they would be covered in their latter years by having paid increasingly larger and larger premiums through the tax-system.  Sorry to say, the reality is that at the present time this is the case.  Yes, the government is scrambling to try to find a way to reestablish coverage in some form but their “plans” at the present are without substance and lost in the pre-election “no-man’s land”.  Will there be some immediate action?  Voters over the age of sixty-five represent a hugely powerful voting-bloc and are among the most vocal members of our society.  The AARP will undoubtedly lobby potential candidates very aggressively to obtain this all-important voting group.  However, as history has shown, I believe that the best that can be expected is something of a stop-gap “band-aid” approach which will potentially destroy the financial lives of these seniors and their heirs. What can be done about this situation?  Although this issue is probably time and space remote to many of our readers, what happens in this healthcare morass will eventually effect every one of us.  I believe that it is imperative that each of us must express to our Federal, State and Local officials our concerns as to the resolution of this impending disaster for our parents and grandparents.  Real change, again in my opinion can only be achieved by an individual proactive stance that is vigorously pursued.  And, in closure, closely observe what you are now paying for healthcare insurance and how rapidly its cost has increased on an annual basis.  The costs are now so high that many small businesses can no longer afford to provide health insurance for their employees as a benefit with result that many valued employees have been forced to leave long-time jobs in search of replacement companies still able to afford this benefit.  Small businesses are the backbone of this "hot-economy".  Without being able to retain valuable long-term people the quality of their services will decline and eventually many will fail.  Therefore, the "domino-effect" of our crumbling healthcare system will eventually be felt by each and every one of us.  How will the insurance companies deal with these questions?  Again, as I have so many times opined, it will be by providing fewer and fewer services for more and more premium cost...bet your bottom-dollar on that. BACK TO SCHOOL & HOLIDAYS The annual return to school and the fast approaching holidays are clearly a time for extra vigilance.  School lunches and holiday treats often contain foods that are potentially destructive of appliances (braces) and the underlying teeth themselves.  We very diligently provide lists of acceptable and unacceptable foods in order to reduce appliance breakage.  Common sense should dictate avoidance of very hard, very sticky and sugar laden foods that can cause decay around the margins of orthodontic attachments.  In our care-kits, we provide "portable" toothbrushes which can be carried to school and we encourage a "brush and swish" after each lunch-period.  As a rule, we suggest that each patient brush their teeth after any food consumption or at least after each of the three daily meals and before bedtime to remove any after-dinner snack residue.  Mechanical toothbrushes are a very efficient and effective tool in the hygiene arsenal…IF THEY ARE USED.  So please, become an oral-hygiene fanatic.  Good oral hygiene and appliance care shortens the period of active treatment and definitely improves the quality of the result. With the return to school after Summer vacation, there will be large number of students who will participate in athletics.  We still see a significant number of accidental mouth injuries that could have been prevented by the wearing of a mouth-guard.  We can provide an appropriate mouth guard for most sports so we encourage you to discuss this with your doctors and staff.  But again, only conscientious wearing of these protective devices can reduce the potential for a serious injury.  As well, the popularity of small "scooters" has rapidly soared.  These devices are even popular with business people in New York City.  Bellevue hospital has reported dozens of serious head injuries daily.  They have recommended that bicycle helmets, knee and arm pads be worn to protect the riders.  If your young family are part of the "scooter-generation" please observe the recommended precautions. NEW TECHNOLOGY - "INVISALIGN" Westwalk Orthodontic Group has always taken pride in being on the leading edge of new technologies.  In a matter of days, you will see in the media a very aggressive promotion of a new orthodontic treatment methodology called "INVISALIGN". ™  In the most basic of terms this appliance modality purports to be able to treat most orthodontic problems with a series of removable appliances thereby obviating the need to place orthodontic attachments (braces) on individual teeth.  Certainly, if this were true it would represent a genuine revolution in a time-tested profession. However, at the present time, the company says that there are, "over 5000 cases in treatment…" Clearly this is only a tiny fraction of cases under treatment in the country.  At the University of Connecticut, our orthodontic department has requested documentation on "completed cases", but as yet, none have been forthcoming. The obvious key to successful orthodontic treatment is excellent patient cooperation, but with the "InvisAlign" method this is a totally patient intensive factor.  The prescribed series of appliances must be worn as near to twenty-four hours per day as possible to produce the required tooth movement. Our initial assessment is that this is a very interesting technology that can be very successful for fairly simple problems if patient cooperation is "exemplary".  We will provide this service on a very select and limited basis, but will withhold final judgment until a great deal more documentation has been provided.  For more details, please feel free to discuss this with our doctors. YET ANOTHER MILESTONE Westwalk Orthodontic Group has been incredibly fortunate to have recruited what we believe is the finest staff in Fairfield County.  Mrs. Paula Deering our office manager and Mrs. Darlene Pironto our laboratory technician in Norwalk passed that milestone in 1998 and 1999 respectively and we are absolutely honored to have been given their loyalty and skillful professionalism.  We pride ourselves in the exceptional longevity of our staff, but most of all on their total dedication to providing the best that orthodontics has to offer. Congratulations Darlene and Paula and thank you from the bottom of our hearts. THE "TRUE" MILLENNIUM I recall thinking about this year many years ago when the Stanley Kubric film (2001) was shown in theaters all over the world; and how far away it seemed since the film was produced in 1969.  How quickly an entire generation and then some has passed and grown into adulthood. About this time last year we were all anxiously awaiting the "New" millennium and, to an extent, with some significant trepidation due to the potential for massive worldwide computer failure.  As it turned out, entering the year 2000 was, in that sense, quite uneventful.  But, in truest terms, the year 2000 was not actually the first year of the new millennium that is actually 2001.We at Westwalk have been privileged to serve a great many of a new and wonderful generation of young people who have and are in the process of becoming the leaders of our society.  We are proud to have been a part of their lives and we are honored that you have selected us as your orthodontists.  We wish you a spectacular New England Fall and holidays filled with the love that reminds us how fortunate we are to live in this great community.